Riley, my 3.5yo male, has been showing what I think are the typical signs of mild to moderate CM/SM the past year. Lots of constant paw chewing, rubbing of the face while excited (almost like a cat grooming itself - rubbing the face with his front paw then licking it), and most notably the typical air-scratching. There are also many times that he'll be walking around excitedly and not quite bunny hop, but one rear leg will seem like it "locks up" in an air-scratching position for a second or two.

My vet and I have run the typical gamut, first starting with ear infection, leading to food allergy, and now unknown environmental allergy. Temaril-P with occasional generic diphenhydramine for the flare-ups has been the usual order for a while now - though they haven't been doing much at all.

So I'm starting to definitely suspect CM/SM of some form, especially after seeing the videos on here and some other Cavalier sites. The only two things that make me question this idea though is the fact that he doesn't yelp at all - even if rubbed at the base of the neck or behind the ears. In fact, he absolutely *loves* it. It's actually one of his ticklish spots. :) Also, it seems the air-scratching and bunny hopping/freezing is notably less when out on his walks. So I'm not really sure whether this is mild CM/SM or just constant inner ear infections. The ears don't really smell infected, and I constantly clean them with ear wash to remove gunk.

Any opinions, and suggestions to the vet for which meds to start off with if we both do suspect mild CM/SM? Thanks!

--Scott

Reptigirl

30th June 2011, 07:39 PM

If your vet has ruled out ear infections he needs to be seen by a neurologist. Many regular vets are not familiar with CM/SM. All 3 of mine were considered neurologically OKAY by 3 different general practice vets. All 3 of mine are suffering from different degrees of CM/SM and needed medication.

My most sever dog doesn't yelp. (over 90% of his spinal cord is filled with a syrinx) I would say a lot of SM affected dogs don't yelp. My pup yelped a few times for unknown reasons but he had VERY strong & early symptoms. ALL of the symptoms you described sound like they *Could* be SM. Ear infections and PSOM can cause similar symptoms. Personally if it was me...from what you described I would be getting a referral to a neurologist ASAP!

You would really need to see a neurologist to get the correct medications. I know my general vets will not prescribe anything for the CM/SM since they are not familiar with it.

The most common medications prescribed for CM/SM are Pregabalin & Gabapentin. Some get steroids &/or fluid reducing medications like omephrozole. Which medication really depends on the severity of each dog & the neurologist treating them. Neurologist usually have to adjust the meds a few times to find what works best for the specific dog.

You can find a list of Board Certified Neurologist here:
http://www.cavalierhealth.org/neurologists.htm

I know I needed a referral to see one. My vet had never heard of SM and really didn't believe my dogs had a reason to see one. She went over the ear infections & had me blindly treating there ears EVERY DAY with ear cleaners. She also had me switch foods since she thought it was allergies. I had to really push to get the referral. Sure enough I was right and my vet was apologizing to me for not thinking we needed to see one. I would print out some of the info on SM & take it to the vet with you. Especially the symptoms list.

Riley, my 3.5yo male, has been showing what I think are the typical signs of mild to moderate CM/SM the past year. Lots of constant paw chewing, rubbing of the face while excited (almost like a cat grooming itself - rubbing the face with his front paw then licking it), and most notably the typical air-scratching. There are also many times that he'll be walking around excitedly and not quite bunny hop, but one rear leg will seem like it "locks up" in an air-scratching position for a second or two.

My vet and I have run the typical gamut, first starting with ear infection, leading to food allergy, and now unknown environmental allergy. Temaril-P with occasional generic diphenhydramine for the flare-ups has been the usual order for a while now - though they haven't been doing much at all.

So I'm starting to definitely suspect CM/SM of some form, especially after seeing the videos on here and some other Cavalier sites. The only two things that make me question this idea though is the fact that he doesn't yelp at all - even if rubbed at the base of the neck or behind the ears. In fact, he absolutely *loves* it. It's actually one of his ticklish spots. :) Also, it seems the air-scratching and bunny hopping/freezing is notably less when out on his walks. So I'm not really sure whether this is mild CM/SM or just constant inner ear infections. The ears don't really smell infected, and I constantly clean them with ear wash to remove gunk.

Any opinions, and suggestions to the vet for which meds to start off with if we both do suspect mild CM/SM? Thanks!

--Scott

Luka was just diagnosed and there was a few months where Luka had no air scratching, he also has a spot behind his ears that when it is stimulated his foot bounces around. The bunny scratching is less on walks because he is focused on something else, do you walk him off leash? Yelping is usually because of severe pain, not mild pain or discomfort.

If I were you I'd get Trupannion (insurance) wait a month and then get the MRI as it is 1600$!

There is PSOM.

If I were you though I'd get him checked by a neurologist.

Karlin

1st July 2011, 02:55 PM

Hi Scott: Air scratching and bunny hopping are pretty definitive indications that you are dealing with SM and from your description this would not likely be mild (eg limited to one or two brief scratching sessions a week, no yelping, nothing happening on a daily basis). From speaking to many vet neurologists and researchers, I gather there isn't anything else they know of which causes this particular action -- it is very distinctive to SM alone. PSOM --which is like glue ear in kids -- does not cause air scratching though it often causes contact scratching and has some other crossover areas of symptoms. All SM dogs are different and while soften signs are more prominent on walks where the dog is on a collar in particular, this is not always the case. Sometimes a harness bothers them more, and sometimes the irritation is triggered by other things. May main SM dog never scratches off lead even on walks of several miles. One never scratches on the lead at all, only when excited. Another scratches while on the lead and sometimes, off.

I do think you need to get an assessment by a neurologist as vets do not really know how to effectively manage a specialist condition. However I would not wait to get insurance if you do not have it -- there is almost no chance now that anything for SM will be covered as you have had him repeatedly in for scratching and suspected ear infections and allergy and these will be well documented -- these will all be seen as early indicators of SM by insurers and are classic early misdiagnoses as mentioned in all the literature on the condition. I think it is more important to get your dog correctly diagnosed and get help for pain and discomfort than to wait a month on the minute chance that insurance would cover what will clearly be seen as a pre-existing condition.

I'd recommend having a look at neurologist Clare Rusbridge's website for detailed SM information and treatment approaches, and be sure to give the link to your vet as well as this will help them identify any similar cases for referral to a neurologist in the future.

http://www.veterinary-neurologist.co.uk/

Let us know how you get on and what you decide to do. :flwr: There are many of us here with SM cavaliers.

sbalmos

17th July 2011, 04:33 PM

Well, a bit of an update here. We went and saw my senior vet, who owns the practice. Surprisingly, he has heard of SM (apparently he sees a lot of Cavaliers). He's open to a referral, if we think it's to that point. However, we are both going to spend the next 3 months retrying a food allergy program, to rule that out. We tried that a year ago, but apparently did it incorrectly, according to the notes he re-diagnosed from his two junior partners (whom I normally see). So we could never definitively rule out a food allergy.

Riley's obsessive air-scratching and rubbing are because his ears are a wreck. They are clean of debris and wax, but badly inflamed. We switched to a disinfecting ear wash - the normal ear wash I use was fine for washing out earwax, but did nothing for the underlying inflammation. He says more probably it irritated the ears even more - kind of like putting a gritty sunscreen on a sunburn, rather than aloe. The Animax ointment I had was fine for brush-fire relief, but solved nothing with the cartilage inflammation.

So, I am cautiously optimistic. It's nice to know that he knows of SM, would have no problem giving a referral, and the vet that originally taught him in vet school is also a small-dog neurologist who has heard of SM, and is local. And that all of his current symptoms may just be from his badly-inflamed ear cartilage and a botched food allergy trial last year.

I'll keep everyone posted as we go along.

Karlin

18th July 2011, 12:52 PM

I hope all that helps; he definitely will feel better from the care for his inflamed ears. :flwr:

I must say -- and I hate to be more skeptical -- according to neurologists, dogs do not air scratch for any reason except SM and I have never heard of them bunny hopping for other reasons either (except perhaps being lame -- eg having a luxating patella and carrying the leg off the ground). If it were ear infections, you'd expect him to scratch and make contact with his ears to address the itch, rather than air scratch.

I don't know if I'd want to wait as long as another three months to at least make a clinical visit to a neurologist familiar with SM. It would be a very long time not to have the underlying discomfort dealt with if it is SM, and may be critical time in which to make decisions that may not be available to you if you wait for many more months and he has this condition and it progresses. I'd certainly see if things improve markedly after his ears get better, but if he is still air scratching and hopping, I do not think it likely that this could be allergies. He may have allergies as well, but I'd definitely want to see a neurologist on the air scratching. It is considered perhaps the most definitive sign of SM as opposed to other underlying causes.

Best of luck with the treatment and let us know how things go.

Blondiemonster

18th July 2011, 03:49 PM

I hope all that helps; he definitely will feel better from the care for his inflamed ears. :flwr:

I must say -- and I hate to be more skeptical -- according to neurologists, dogs do not air scratch for any reason except SM and I have never heard of them bunny hopping for other reasons either (except perhaps being lame -- eg having a luxating patella and carrying the leg off the ground). If it were ear infections, you'd expect him to scratch and make contact with his ears to address the itch, rather than air scratch.

I don't know if I'd want to wait as long as another three months to at least make a clinical visit to a neurologist familiar with SM. It would be a very long time not to have the underlying discomfort dealt with if it is SM, and may be critical time in which to make decisions that may not be available to you if you wait for many more months and he has this condition and it progresses. I'd certainly see if things improve markedly after his ears get better, but if he is still air scratching and hopping, I do not think it likely that this could be allergies. He may have allergies as well, but I'd definitely want to see a neurologist on the air scratching. It is considered perhaps the most definitive sign of SM as opposed to other underlying causes.

Best of luck with the treatment and let us know how things go.

Great advice!!! Let us know how it goes!

Holly

18th July 2011, 11:23 PM

You might consider at least getting a consultation with the neurologist. They can't definitively diagnose without the MRI but can advise you better than a General Vet. The air scratching and bunny hopping would definitely have me concerned and thinking more along the lines of SM. Try to video his episodes to show the neurologist and also look at some of the videos online of dogs exhibiting SM symptoms that have already been diagnosed. Three more months seems like an awfully long time to wait if he is having discomfort. Treat his ears, of course, but I would look into the neurologist. I believe I paid around $200 here in Atlanta (maybe a bit less)-- not sure where you are located. Check on Rod's website: www.cavalierhealth.org for a list of board certified neurologists in your area.

Holly

18th July 2011, 11:26 PM

Also, my SM girl doesn't yelp either and LOVES to have her head and neck area rubbed/massaged. Her meds (fGabapentin and Omeprazole) really help her but when they wear off and before she was on meds, there was a good bit of air scratching, bunny-hopping (just like you describe with the back leg), and excessive digging in her bedding. She also fly catches-- but no one has been able to tell me if that is related to her SM- though I suspect it is.